| NPI | 1134330079 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OH 35.091835) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35091835) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2012-03-07 |